| Entity Name: | PALM HAVEN ASSISTED LIVING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Mar 2010 (15 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P10000019538 |
| Address: | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| Mail Address: | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| ZIP code: | 33063 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770806002 | 2010-03-01 | 2010-03-01 | 1646 W RIVER DR, MARGATE, FL, 330632729, US | 1646 W RIVER DR, MARGATE, FL, 330632729, US | |||||||||||||||||
|
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| Phone | +1 954-471-6303 |
Authorized person
| Name | ZEB GARDNER |
| Role | PRESIDENT |
| Phone | 9544716303 |
Taxonomy
| Taxonomy Code | 3104A0630X - Assisted Living Facility (Behavioral Disturbances) |
| License Number | PTA012528 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GARDNER ZEB | Agent | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| Name | Role | Address |
|---|---|---|
| GARDNER ZEB | President | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| Name | Role | Address |
|---|---|---|
| SAFAIA STEVE | Vice President | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| ACKBERSIGHN GENA | Vice President | 1646 N. RIVER DRIVE, MARGATE, FL, 33063 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2010-03-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
